Melena is often misidentified by resident physicians early in their careers; in addition, rectal exam (RE) completion rates are low among residents, contributing to inaccurate gastrointestinal (GI) consultations for melena. Precise melena identification can have important diagnostic and therapeutic implications. We designed a stool color card (SCC; Figure 1) and prospectively examined whether SCC implementation, as part of residency training, will improve percentage of REs completed, accurate melena identification, and RE concordance between residents and GI consultants.